A drug that was originally created to tackle malaria has gained attention as a possible treatment for Covid-19.

In the race to find a treatment for Covid-19, anti-malarial drugs hydroxychloroquine and chloroquine are being punted as a possible solution. The drugs, which has been extensively punted by US President Donald Trump, is currently being used in a number of trials across the world but so far, the results remain inconclusive. 

A study conducted at the Renmin Hospital in the city of Wuhan in China, the epicentre of the pandemic, at the end of March 2020, found that of the 62 patients with mild illness who were treated with hydroxychloroquine, those treated with the drug showed some signs of a quicker recovery compared to those who had been given a placebo.

An article in the New York Times reporting on the Wuhan trial, reported that, “Coughing and fever eased a day or so earlier in the patients who received hydroxychloroquine, and pneumonia improved in 25 of 31, as opposed to 17 of 31 in the controls. The illness turned severe in four patients — all in the control group. Two patients had minor side effects from hydroxychloroquine: One had a rash and another had a headache.”

Another study in Brazil was abruptly halted last week after patients who were given higher doses of chloroquine, a variant of hydroxychloroquine, developed irregular heart beats. The drug is known to have heart-related side effects. The study, conducted on 82 hospitalised patients, was limited in that researchers were not able to include a placebo as part of the trial.  The New York Times reported that, “Despite its limitations, infectious disease doctors and drug safety experts said the study provided further evidence that chloroquine and hydroxychloroquine, which are both used to treat malaria, can pose significant harm to some patients, specifically the risk of a fatal heart arrhythmia”. 

Both hydroxychloroquine and chloroquine are registered as anti-malarials in South Africa. 

Dr Jeremy Nel who is a member of the University of Witwatersrand Internal Medicine Department told Wits Vuvuzela: “The role of chloroquine is currently unknown. There has been some somewhat promising but very inconclusive data from other countries so far, but nothing that allows us to say definitively whether chloroquine works or not. Several studies are underway to try clarify this.”

Nel who is also working on the Public Health Emergency Solidarity Trial created by the World Health Organisation (WHO) to find an effective treatment for Covid-19, said that South Africa should approach chloroquine with caution. Nel says that that the drug is still in an experimental phase and should only be used under the conditions of human clinical trials. According to Nel, trials are often safer than providing off-label prescriptions of medications too due to the “stringent safety monitoring safety protocols in place.” ‘Off-label’ refers to instances where medicines are used for illnesses or conditions other than those they are intended for. 

Chloroquine is one of the drugs being tested in the WHO Solidarity international study which hopes to find an effective treatment for Covid-19. The  other drugs in the trial  Remdesivir which was previously used as treatment for Ebola, Lopinavir/Ritonavir which is licensed in HIV treatment and Inteferon beta-1a which is typically used to treat sclerosis. 

Andy Gray, senior lecturer at the medical school for the University of KwaZulu-Natal speaking to Wits Vuvuzela said that, “Given the paucity of evidence, and the risks of doing harm, South Africa has responded appropriately and cautiously, by prioritising use (of chloroquine) in approved clinical trials.”

It needs to be stressed that there is currently no drug/vaccine that has been proven to be effective against Covid-19 as international trials remain inconclusive. 

FEATURED IMAGE: Chloroquine has come under the spotlight as one of the drugs being tested as a possible treatment for Covid-19. Photo: Dylan Bettencourt.